Backtable Cardiology

Will new PE guidelines redefine risk and therapy in pulmonary embolism (PE) care? In this episode of the BackTable podcast, host Dr. Michael Barraza is joined by interventional cardiologist Dr. Jay Giri and emergency physician Dr. Trevor Cummings to break down the latest changes in PE management. They discuss how multidisciplinary pulmonary embolism response teams (PERT) are implementing these guidelines at their institutions, the introduction of a more nuanced A-E risk stratification system, and the challenges of enrolling experienced centers into clinical trials as device innovation accelerates. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Inari Medicalhttps://www.inarimedical.com/flowtriever-system --- Timestamps 00:00 - Introduction 01:24 - Building a PERT Team04:59 - Trials Shaping PE Care 10:20 - Why New Guidelines Now 14:06 - New Risk Categories Explained 19:51 - Applying Guidelines Locally 23:34 - What Is C1 Risk 27:52 - New D Category Explained 30:33 - Evidence for Aggressive Therapy 33:31 - How PERT Teams Communicate 38:22 - Upcoming PE Trials Pipeline 43:42 - Program Growth and High Risk Trials 45:46 - Closing Remarks --- More about this episode The conversation highlights the growth of catheter-directed lysis and mechanical thrombectomy, the rationale and practical impact of the new Category D for incipient cardiopulmonary failure (including normotensive shock), and the incorporation of PESI, sPESI, and Hestia for risk assessment. Additional topics include decision-making for low-risk patients, lactate and biomarkers for identifying higher-risk cases, communication strategies within PERT teams, AI-enabled risk stratification, and a preview of upcoming trials (PEITHO, PRAGUE-26, PEERLESS-2, PE-TRACT, and PERSEVERE) that are set to further transform PE care. --- Resources Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/21422387/ Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/36688837/ Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/31585051/ Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolismhttps://pubmed.ncbi.nlm.nih.gov/41910345/ PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolismhttps://pubmed.ncbi.nlm.nih.gov/39132600/ Rationale and design of the PE-TRACT trial: A multicenter randomized trial to evaluate catheter-directed therapy for the treatment of intermediate-risk pulmonary embolismhttps://pubmed.ncbi.nlm.nih.gov/39638275/ Reduced-Dose Intravenous Thrombolysis for Acute Intermediate–High-risk Pulmonary Embolism: Rationale and Design of the Pulmonary Embolism International THrOmbolysis (PEITHO)-3 trialhttps://pubmed.ncbi.nlm.nih.gov/34560806/ Design and rationale of the PERSEVERE study: a randomized controlled trial of large-bore mechanical thrombectomy versus the standard of care for high-risk pulmonary embolism https://pubmed.ncbi.nlm.nih.gov/41453591/ Design and rationale of PRAGUE-26: a multicentre, randomised trial of catheter-directed thrombolysis for intermediate-high risk acute pulmonary embolismhttps://pubmed.ncbi.nlm.nih.gov/40464677/ --- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Could persistent dyspnea after a “resolved” PE be more than just deconditioning or diastolic dysfunction? In this episode of BackTable Cardiology, Dr. Hady Lichaa hosts interventional cardiologist and vascular medicine specialist Dr. Vladimir Lakhter, to discuss the diagnosis and management of CTEPH and chronic thromboembolic disease (CTED). They review the prevalence of CTEPH following pulmonary embolism, common delays in diagnosis, and why symptoms such as dyspnea are often misattributed to conditions like diastolic dysfunction. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:40 - Defining CTEPH07:00 - Diagnostics for Detection12:02 - Treatment Considerations16:08 - Anatomy Challenges22:03 - Device Options and Techniques29:40 - BPA Procedure39:50 - Interpreting Angiographic Appearance of CTEPH48:10 - BPA Challenges and Risks52:06 - Diuretics 55:10 - Post BPA Diagnostics and Complications01:02:42 - Treatment Endpoints01:06:10 - Continuing Education and Expert Resources01:08:41 - Closing Thoughts --- More about this episode Dr. Lakhter outlines a practical diagnostic workup, emphasizing the Ventilation-Perfusion (V/Q) scan as the key screening test, supplemented by thin-cut CT pulmonary angiography and transthoracic echocardiography (TTE). He then explains how treatment decisions are made within a multidisciplinary framework, balancing medical therapy, surgical pulmonary endarterectomy (the curative gold standard for surgically accessible disease), and balloon pulmonary angioplasty (BPA) for patients with distal disease, residual pulmonary hypertension after surgery, or those who are not surgical candidates. Drs. Lichaa and Lakhter dive into a detailed procedural overview of BPA, including pulmonary artery anatomy resources, pulmonary angiography technique, access and equipment selection, lesion classification, and intraprocedural assessment using pressure wires and venous return patterns. Dr. Lakhter shares practical strategies to minimize complications, including undersized balloon sizing to reduce reperfusion pulmonary edema, routine post-procedure diuresis, and management of complications such as pulmonary artery injury and tamponade using Gelfoam, coils, and, in rare cases, vascular plugs. They finish the conversation with a closer look at typical BPA staging and treatment endpoints. --- Resources Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Dr. Vladimir Lakhter’s Provider Profilehttps://www.templehealth.org/doctors/vladimir-lakhter Balloon Pulmonary Angioplasty (BPA) for Treatment of Chronic Thromboembolic Pulmonary Hypertension (CTEPH)https://pubmed.ncbi.nlm.nih.gov/11136677/ --- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

From clot to clear flow, minimally invasive aspiration devices are PAVE-ing the way for safer treatment of endocarditis and cardiac masses. In this BackTable Cardiology episode, host Dr. Hady Lichaa sits down with Dr. Abdallah El Sabbagh to discuss percutaneous continuous-flow aspiration for right- and select left-sided endocarditis and cardiac masses. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Angiodynamicshttps://9zfaiv.short.gy/cardiovascular-backtable --- Timestamps 00:00 - Introduction03:43 - Lessons in Fibroelastoma 12:01 - Imaging Workup14:24 - Transesophageal Echocardiography (TEE) vs Intracardiac Echocardiography (ICE)17:52 - AngioVac System Components20:33 - Access Strategy, Sheath Size and Flow Rates23:41 - Adjunct Tools and Retrieval Options31:35 - Using Continuous Aspiration47:16 - Percutaneous AngioVac Vegetation Extraction (PAVE) Trial 53:17 - Future Devices Wishlist --- More about this episode Dr. El Sabbagh provides guidance on removing papillary fibroelastomas, emphasizing matching technique to mass characteristics and combining tools such as continuous aspiration with electrosurgical snaring to address adherent stalks. Their conversation covers patient selection for off-label endocarditis intervention, including intravenous drug use and Cardiac Implantable Electronic Device (CIED) lead infections, use of aspiration as definitive therapy, and imaging/workflow preferences. Dr. El Sabbagh details the AngioVac system, access strategies, adjunct devices, mitigating complications, and registry outcomes. He touches on the need for prospective studies, including the Percutaneous AngioVac Vegetation Extraction (PAVE) clinical trial. To finish the conversation, Drs. Lichaa and El Sabbagh look ahead to building future devices and provide advice on creating multidisciplinary programs as well as training pathways. --- Resources Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Dr. Abdallah El Sabbagh’s Provider Profilehttps://www.mayoclinic.org/biographies/el-sabbagh-abdallah-m-d/bio-20466764 Percutaneous AngioVac Vegetation Extraction (PAVE) to Remove Right Heart Vegetations in Patients With Infective Endocarditis - PAVE Clinical Trialhttps://clinicaltrials.gov/study/NCT07282002 --- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Small vessels can have a major impact. Are you missing the hidden culprit of chest pain? In this episode of BackTable Cardiology, host Dr. Hady Lichaa welcomes Yale Interventional Cardiologist Dr. Samit Shah to discuss Coronary Microvascular Dysfunction (CMD) and Angina with No Obstructive Coronary Arteries (ANOCA). Their discussion demonstrates how coronary function testing turns a historically vague diagnosis into actionable phenotyping that can dramatically improve treatment efficacy and patient symptoms. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:53 - Coronary Microvascular Dysfunction (CMD) Overview10:55 - Cath Lab Workflow Tips19:28 - Structural CMD: Discordant CFR and IMR Values26:59 - Vasospastic Phenotypes28:28 - Chest Pain Case: Syncope and Arrest Risk33:31 - Treatment and ACh Testing39:10 - Mixed Physiology Pharmacotherapy49:45 - Myocardial Bridge Workup55:19 - Workflow, Reimbursement, and Future Therapies58:11 - Closing and Signoff --- More about this episode Dr. Shah breaks down clinical presentations and cath lab findings of epicardial vasospasm, microvascular spasm, and endothelial dysfunction, outlining how phenotype and physiology influence treatment. He explains how to perform both Coronary Flow Reserve (CFR) and Index of Microcirculatory Resistance (IMR) testing, incorporating examples of interpretation of abnormal values. The physicians discuss COVADIS criteria for vasospastic angina, vasospasm and cardiac arrest considerations, and myocardial bridges in LAD-PCI. The episode covers door-to-discharge care for CMD: identification of phenotype via patient case walk-throughs, practical cath lab workflow, and recommendations for tailored pharmacotherapy. --- Resources Dr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa Dr. Samit Shah’s Provider Profile https://medicine.yale.edu/profile/samit-shah/ COVADIS Criteria for vasospastic anginahttps://covadis.online/definitions/ A doppler flow probe for canine main left coronary arterieshttps://journals.physiology.org/doi/abs/10.1152/jappl.1974.37.2.256?journalCode=jappl ChaMP-CMD: A Phenotype-Blinded, Randomized Controlled, Cross-Over Trialhttps://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066680 Presence and Relevance of Myocardial Bridge in LAD-PCI of CTO and Non-CTO Lesions https://pubmed.ncbi.nlm.nih.gov/38340105/ DEFINE GPS Trialhttps://clinicaltrials.gov/study/NCT04451044 --- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Coronary sinus reducers: the hourglass-shaped stents that might be able to take patients back to angina-free times. In this BackTable Cardiology Brief, Dr. Jai Khatri and Dr. Ziad Ali discuss patient selection, treatment algorithms, and recent, clinical-trial backed technology for treating diffuse, multi-vessel atherosclerotic disease. They emphasize staged PCI, careful counseling, and setting realistic expectations when angiographic success doesn’t translate to symptom relief. Notably, the episode introduces the coronary sinus reducer, tracing the stent’s roots back to the Beck procedure of the 1950s. Drs. Jai and Khatri review the stent’s mechanism in the coronary sinus and review key coronary sinus reducer trials: COSIRA and COSIRA-II. The delve into COSIRA-II’s design, inclusion criteria, and best practices and recommendations for enrolling patients. --- Timestamps 00:00 - Introduction 00:59 - Diffuse Disease Challenges 02:42 - Patient Communication: Setting Expectations 05:06 - Treatment Algorithms: PCI vs CABG 07:22 - When PCI Fails Symptoms 08:35 - Coronary Sinus Reducers 10:52 - COSIRA Evidence 12:01 - COSIRA II Design 13:13 - Why Sham Control Matters 14:30 - Reducer Procedure Walkthrough 16:54 - Risks And Safety 18:41 - Enrollment And Criteria 20:11 - Wrap Up And Credits --- Check out the full episode COSIRA II: Managing Refractory Angina in Clinical Practice https://www.backtable.com/shows/cardiology/podcasts/14/cosira-ii-refractory-angina-challenges-treatment-strategies --- Resources COSIRA-II Trial https://clinicaltrials.gov/study/NCT05102019

Understanding when to use extracorporeal membrane oxygenation (and how) can be extra complex, but knowing the intricacies of ECMO is key to using it effectively. In this episode of BackTable Cardiology, Dr. Hady Lichaa sits down with Dr. Allison Dupont to approach ECMO in a practical, clinically relevant way. They cover the fundamentals, including VV versus VA ECMO, circuit components, and key settings like flow, oxygenation, and CO2 removal. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:19 - What Is ECMO12:19 - Who Should Get ECMO16:12 - ECPR Criteria and Triage29:45 - Access Strategy32:43 - Low Flow Troubleshooting44:24 - Anticoagulation Protocols48:21 - Chugging Volume Alarms50:25 - Weaning Off ECMO55:22 - Building An ECMO Program --- More about this episode The conversation also dives into real-world application, including cannulation strategies, typical flow parameters, troubleshooting low flow, preventing limb ischemia, and managing anticoagulation. They explore advanced topics like LAVA-ECMO for valvular disease, ECPR protocols inspired by the ARREST Trial, and how to think about patient selection and “bridge” strategies. Dr. DuPont finishes with practical insights on weaning, LV unloading, bleeding management, and what it takes to successfully build an ECMO program with a multidisciplinary team.---ResourcesDr. Hady Lichaa’s Provider Profilehttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaaDr. Allison Dupont’s Provider Profilehttps://northsidecvi.com/providers/our-cardiologists/allison-dupontAdvanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trialhttps://pubmed.ncbi.nlm.nih.gov/33197396/

TAPAS, TASTE, TOTAL. These are the names of clinical trials that re-evaluated the use of manual aspiration thrombectomy in STEMI. In this episode of BackTable Cardiology, host Dr. Sameh Sayfo interviews Dr. Andrew Goldsweig, Director of Cardiovascular Clinical Research at Baystate Medical Center and Chair of the SCAI Standards and Guidelines Committee, about coronary thrombectomy in contemporary PCI. --- This podcast is supported by an educational grant from Cheisi. --- SYNPOSIS Drs. Sayfo and Goldsweig review how evidence from major trials led to a Class III recommendation against routine manual aspiration thrombectomy in STEMI, discuss methodological differences among studies and concerns about stroke reporting, and clarify how selective or bailout use may still have a role in high thrombus-burden cases. Their conversation also covers growing interest in mechanical thrombectomy technologies, the design and limitations of newer device studies, practical considerations that influence adoption, and differing operator approaches to STEMI workflows. They conclude by discussing gaps in evidence, the need for comparative data, and potential future features of next-generation coronary thrombectomy devices. --- TIMESTAMPS 00:00 - Introduction02:51 - Manual vs Mechanical Thrombectomy03:56 - TAPAS, TASTE, and TOTAL Trials10:20 - CHEETAH Trial Breakdown13:05 - Practice Patterns and Billing16:26 - Step by Step STEMI Workflow20:09 - Door to Balloon Reality22:03 - Impella First Strategy24:08 - High Thrombus Scenarios33:30 - Wishlist Catheter Features --- RESOURCES Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Andrew Goldsweig’s Provider Profilehttps://www.baystatehealth.org/providers/andrew-m-goldsweig A Prospective, Multicentre, Long-Term Cohort Study in Children, Adolescents and Adults with Seasonal Allergic Rhinitis-Design and Early Results (TAPAS)https://pubmed.ncbi.nlm.nih.gov/40283440/ Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction (TASTE)https://www.nejm.org/doi/full/10.1056/NEJMoa1308789 Randomized Trial of Primary PCI with or without Routine Manual Thrombectomy (TOTAL)https://www.nejm.org/doi/full/10.1056/NEJMoa1415098 CHEETAH Study by Penumbrahttps://www.penumbrainc.com/cheetah-study-results/

John Doe is a 45 year-old male with a past medical history of hypertension, on high doses of amlodipine, metoprolol and lisinopril presenting to his cardiologist with a blood pressure of 165/86. He asks, “If the medications are not controlling my blood pressure, what are my options?” In this episode of the BackTable Cardiology Podcast, Dr. Sameh Sayfo sits down with Dr. Eric Secemsky, an internationally recognized interventional cardiologist and vascular medicine specialist to discuss renal denervation, a minimally invasive procedure that lowers blood pressure by disrupting overactive renal sympathetic nerves. --- SYNPOSIS From its proof of concept to the clinical trials that have shaped the current landscape, Drs. Sayfo and Secemsky dive into the intricacies of renal denervation. They explore the technical aspects of catheter-based denervation devices like Medtronic's Spyral catheter and Recor's Paradise device, discussing their procedures, safety features, and troubleshooting tips. The conversation also covers the significance of building advanced hypertension centers, the latest in renal denervation innovations, and the creation of a national registry to track procedural outcomes and enhance patient care. --- TIMESTAMPS 00:00 - Introduction02:52 - Guidelines Update: Why Renal Denervation Earned a Class 2B Recommendation07:31 - Clinical Trials: What Went Wrong, What We Learned, and How Devices Improved15:08 - Medtronic Symplicity Spyral22:17 - ReCor Paradise27:30 - Covering the Main Renal Artery: Anatomic Variants and Proximal Treatment Strategy33:15 - Beyond Kidneys: Multi-Organ Denervation and Metabolic Effects40:27 - Why Institutions Should Build Hypertension Centers --- RESOURCES Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayf Dr. Eric Secemsky’s Provider Profilehttps://findadoc.bidmc.org/details/3519 A Controlled Trial of Renal Denervation for Resistant Hypertensionhttps://www.nejm.org/doi/full/10.1056/NEJMoa1402670 Medtronic Symplicity Spyral™ Renal Denervation Systemhttps://www.medtronic.com/en-us/healthcare-professionals/products/surgical-energy/ablation/radiofrequency-ablation/systems/symplicity-spyral-renal-denervation-system.html SPYRAL GEMINI Pilot Studyhttps://clinicaltrials.gov/study/NCT06907147 Ablation of Arteries for the Treatment of Type 2 Diabetes Mellitus and Its Comorbidities (NECTAR IV) Trial https://clinicaltrials.gov/study/NCT05369065

This is a friendly reminder to unclench your jaw, sit up straight, and take a deep breath before diving into the latest episode of BackTable Cardiology! Host Dr. Sameh Sayfo from Baylor Scott & White Health speaks with Dr. Sahil Parikh, a renowned interventional cardiologist from Columbia University, about the health of interventional cardiologists. They discuss the various occupational hazards interventional cardiologists may be at risk for, particularly focusing on radiation exposure and orthopedic injuries caused by wearing lead aprons. The conversation touches on the need for better education and mandatory training for upcoming cardiologists to prevent such injuries. --- SYNPOSIS As Dr. Parikh shares his personal experiences with orthopedic issues related to the extensive use of lead protection, he highlights the importance of radiation safety and advocates for incorporating advanced protective technologies in the labs. Dr. Sayfo and Dr. Parikh also discuss the significant trials presented at TCT 2025, their potential impact on clinical practice, and the importance of advocacy by societies like SCAI and the American College of Cardiology (ACC) in improving interventional cardiologists' working conditions. --- TIMESTAMPS 00:00 - Introduction01:58 - Orthopedic Issues in Interventional Cardiology04:00 - The Impact of Wearing Lead13:06 - Ergonomics and Risk Factors15:47 - Preventative Measures and Solutions23:22 - The Role of Medical Societies27:00 - Radiation Reduction Devices Overview30:57 - Barriers to Adopting Safety Technologies35:40 - Addressing Burnout in Interventional Cardiology42:06 - Highlights from TCT 2025 --- RESOURCES Dr. Sahil Parikh Provider Profile https://doctors.columbia.edu/us/ny/new-york/sahil-a-parikh-md-161-fort-washington-avenue Dr. Sameh Sayfo Provider Profile https://www.bswhealth.com/physician/sameh-sayfo Cardiovascular Research Foundation's Transcatheter Cardiovascular Therapeutics (CRF TCT) Conference 2025 - The Global Forum for Interventional Cardiology https://www.tctconference.com/ Society for Cardiovascular Angiography & Interventionshttps://www.scai.org/ American College of Cardiologyhttps://www.acc.org/

Fast acting and reversible: IV cangrelor offers rapid on, rapid off P2Y12 platelet inhibition that sidesteps oral absorption delays. In this episode of the BackTable Cardiology Podcast, host Dr. Sameh Sayfo welcomes renowned interventional cardiologist Dr. Roxana Mehran, incoming President elect of the American College of Cardiology (ACC), to discuss the emerging role of cangrelor and its implications on current cardiology practice. --- This podcast is supported by an educational grant from Cheisi. --- SYNPOSIS Dr. Mehran and Dr. Sayfo cover the history and outcomes of the CHAMPION PHOENIX trial, cangrelor’s adoption and underutilization, and the nuances of transitioning high acuity patients between IV and PO antiplatelet therapies. Dr. Mehran also addresses the role of gender in cardiovascular health and the importance of inclusive representation in clinical studies. The episode concludes with Dr. Mehran sharing her initiatives to support women and minorities in cardiology, including her work as co-founder of Women As One. --- TIMESTAMPS 00:00 - Introduction to the BackTable Podcast01:57 - Understanding Cangrelor and Its Impact02:18 - CHAMPION PHOENIX Study Insights07:02 - Challenges and Misconceptions of Cangrelor in Cardiogenic Shock and STEMI14:41 - Antiplatelet Bridging to Surgery and Gender Differences in Treatment17:39 - The SMILE Study and Real-World Applications20:49 - Advancing Women in Cardiology29:22 - Future of Interventional Cardiology32:53 - Holistic Cardiac and Vascular Health36:01 - Conclusion and Final Thoughts --- RESOURCES Dr. Roxana Mehran:https://profiles.mountsinai.org/roxana-mehran Dr. Sameh Sayfo:https://www.bswhealth.com/physician/sameh-sayfo Effect of Platelet Inhibition with Cangrelor during PCI on Ischemic Events (CHAMPION PHOENIX Trial):https://www.nejm.org/doi/full/10.1056/NEJMoa1300815 Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition – CHAMPION Platform Clinical Trialhttps://www.clinicaltrials.gov/study/NCT00385138 Intravenous Platelet Blockade with Cangrelor during PCI (CHAMPION PCI):https://www.nejm.org/doi/full/10.1056/NEJMoa0908629 Meta-Analysis of the Role of Cangrelor for Patients Undergoing Percutaneous Coronary Interventionhttps://www.sciencedirect.com/science/article/abs/pii/S0002914919300426 Timing, indications and transition patterns associated with cangrelor use in patients undergoing PCIhttps://pubmed.ncbi.nlm.nih.gov/40813532/ Women As Onehttps://womenasone.org/about/

Clinicians play a central role in shaping cardiovascular innovation, yet many lack a clear pathway to participate. In this episode of BackTable Cardiology, Dr. Sameh Sayfo speaks with Dr. Mohamad Alkhouli, cardiologist and Chair of Research and Innovation at the Mayo Clinic, about practical approaches for clinician involvement in healthcare innovation and strategies to address persistent gaps in cardiovascular care access. --- SYNPOSIS The discussion examines Dr. Alkhouli’s decision to pursue an MBA, the role of business and organizational training in medical leadership, and how system-level thinking informs innovation beyond device development. Broader themes include stakeholder alignment, organizational behavior, and emerging opportunities for non-device innovation within contemporary cardiovascular practice. --- TIMESTAMPS 00:00 - Introduction01:49 - The Value of an MBA for Physicians05:24 - Understanding Systems and Organizational Behavior07:31 - Navigating Innovation in MedTech13:15 - Bridging the Gap Between Physicians and Business19:44 - The Role of Professional Societies in Innovation25:32 - Future Trends in Interventional Cardiology29:58 - Global Perspectives on Innovation31:47 - Closing Remarks and Credits --- RESOURCES American College of Cardiologyhttps://www.acc.org/ Bolt Medical AcquisitionBoston Scientific Announces Agreement to Acquire Bolt Medical, Inc. Silk Road Medical AcquisitionBoston Scientific Closes Acquisition of Silk Road Medical, Inc. Dr. Mohamad Alkhouli’s Provider Profile https://www.mayoclinic.org/biographies/alkhouli-mohamad-m-d-m-b-a/bio-20465257 Dr. Sameh Sayfo’s Provider Profilehttps://www.bswhealth.com/physician/sameh-sayfo

From sternotomy to software, the booming field of robotic cardiac surgery is bringing new minimally invasive treatment approaches to well-traveled cardiology conditions. This week on the BackTable Cardiology Podcast, Dr. Amber Edwards, a distinguished cardiothoracic surgeon from Ascension St. Thomas in Nashville, shares her expertise in robotic cardiac surgery with host and Tennessee neighbor Dr. Hady Lichaa. The two physicians discuss the growth and technical advancements within robotic cardiac surgery, including the burgeoning field of hybrid revascularization. --- SYNPOSIS Dr. Edwards outlines her journey in the cardiothoracic field, sharing her experiences with pioneers of minimally invasive and robotic cardiac surgeries. The discussion explores various procedures, including totally endoscopic coronary artery bypass (TECAB), minimally invasive direct coronary artery bypass (MIDCAB), and robotic LIMA to LAD bypass. Dr. Edwards also elaborates on robotic left atrial appendage ligations, robotic mitral and aortic valve surgeries, and conversion procedures for atrial fibrillation, highlighting their technical challenges, patient selection, and potential for broader adoption. --- TIMESTAMPS 00:00 - Introduction03:33 - MIDCAB and TECAB Procedures07:11 - Preoperative Testing and Considerations09:09 - Challenges and Complexities in Robotic Surgery17:20 - Hybrid Revascularization and Antiplatelet Therapy26:02 - The Future and Adoption of Robotic Surgery30:56 - Exploring Robotic Left Atrial Appendage Ligation32:03 - The Convergent Procedure for AFib Patients40:56 - Robotic Mitral Valve Surgery: Techniques and Benefits47:11 - The Future of Robotic Cardiac Surgery50:20 - Conclusion --- RESOURCES Dr. Amber Edwardshttps://healthcare.ascension.org/find-care/provider/1699031591/amber-edwards Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa REvascularization CHoices Among Under-Represented Groups Evaluation: The RECHARGE Trial - Women (RECHARGE:W)https://clinicaltrials.gov/study/NCT06399692

Transcatheter aortic valve replacement (TAVR) may be a standard cardiac procedure today, but its origin story follows an intriguing tale of courage, innovation and heart. In this episode of BackTable Cardiology, renowned cardiothoracic surgeon Dr. Michael Mack, a global leader in structural heart disease from Baylor Scott White Health, shares the history of TAVR, highlighting its origins, key clinical trials, and the eventual success of TAVR as a primary therapy. --- SYNPOSIS Dr. Michael Mack and host Dr. Sameh Sayfo discuss the early adaptations, challenges, and adoption of TAVR, detailing the collaborative efforts amongst medical professionals that led to its widespread utilization. They also explore the future of valve technology and the importance of multidisciplinary teamwork in advancing cardiovascular care. The discussion concludes with insights into emerging heart technologies and the evolving partnership between different medical specialties. --- TIMESTAMPS 00:00 - Introduction02:27 - Inception of TAVR03:01 - The Global Reach of TAVR11:10 - Placement of Aortic Transcatheter Valves (PARTNER) Trial 19:10 - Advancements in Cardiac Imaging20:35 - Mapping the Next Five Years23:20 - Strides in Aortic Insufficiency 25:16 - Collegiality in Cardiac Care --- RESOURCES How Transcatheter Aortic Valve Implantation (TAVI) Was Born: The Struggle for a New Inventionhttps://pmc.ncbi.nlm.nih.gov/articles/PMC8511628/ Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgeryhttps://www.nejm.org/doi/full/10.1056/NEJMoa1008232 Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Yearshttp://nejm.org/doi/full/10.1056/NEJMoa2307447 Dr. Michael Mack Provider Profileshttps://news.bswhealth.com/en-US/photos/michael-mack-md Dr. Sameh Sayfo Provider Profilehttps://www.bswhealth.com/physician/sameh-sayfo